As prescription drug costs continue to increase, it’s important for employers to understand the trends behind the rise and what they can do to better manage their health care expenses.

This blog post sets out to provide context for why prescription prices continue to rise and offers cost-cutting solutions for employers and employees.

Prescription Drug Cost Drivers

In 2019, the United States spent nearly $370 billion on prescription drugs, keeping trend with significant increases year over year. Although prescription drug spending has historically been a small proportion of national health care costs compared to hospital and physician services, it has grown rapidly in recent years—comprising about 10% of national health care spending.

A multitude of reasons led to this steady rise in prescription drug costs, including the following.

Influx of Specialty Drugs

Specialty medications account for a smaller portion of U.S. prescriptions than non-specialty drugs, yet they commanded nearly half of the pharmaceutical market in 2016 ($180 billion). And that dominance is likely to remain. Specialty drug spending is projected to experience rapid growth over the next several years, due to pricing increases.

Employers that are interested in cutting their health care expenses are likely familiar with telehealth. This is the process of communicating with a doctor via an app, or a webcam and computer. During the COVID-19 pandemic, telehealth usage skyrocketed, making it one of the most popular ways to receive health care.

As such, employers should stay apprised of notable telehealth trends to ensure they stay competitive and provide the best health care options to their employees. This article discusses five telehealth trends to watch for in 2021.

1. More Patient Utilization of Telehealth

As was stated, telehealth exploded in popularity during the COVID-19 pandemic. To put that into figures, nearly half (43.5%) of Medicare primary care visits in April 2020 were made using telehealth, according to the Department of Health and Human Services. And even before the pandemic, year-over-year utilization was up 33% in early 2020, according to Medical Economics.

If these statistics aren’t enough to prove that telehealth is here to stay, look instead at market projections. The telehealth market is estimated to surmount $185 billion by 2026, according to Fortune Business Insights. Considering the market was only worth around $34 billion in 2018, this shows how much of an impact telehealth has made on the health care industry.

Almost half of Americans state they will not get vaccinated against the COVID-19 coronavirus – at least not right away. Some of this stems from the speed at which the vaccines are being developed, but also from a segment of the population that has always been suspicious of any vaccines (so-called anti-vaxxers).

The possibility that large swaths of the U.S. population may refuse or delay getting any one of the COVID-19 vaccines presents a serious challenge to the nation's health and the health of our business economy.

Employers are in a unique position to help propel vaccinations, accelerating the country towards the 75% vaccination target that has been cited by top infectious disease experts as being required to fully eliminate the need for social distancing.

Company leaders find themselves in this unique position because it's widely believed that they can, in most cases, legally compel their employees to get vaccinated, making it compulsory and a requirement for returning to work.

Now just because something can be done doesn't necessarily mean it should be done. There are persuasive arguments to be made on both sides of the issue. There are also some exceptions to consider, and some basic questions to be answered, such as where to even start among the workforce. We'll do our best to answer a few of these questions today.

Given the tremendous challenges surrounding in-person gatherings, employers everywhere have been torn between hosting, postponing, or outright canceling their company holiday parties in the face of the COVID-19 pandemic.

In fact, according to Challenger, Gray & Christmas, a Chicago-based outsourcing firm that conducts an annual survey of workplace holiday festivities, most employers are either canceling their parties altogether or are hosting them virtually this holiday season. 

Their annual survey found that only 23 percent of organizations plan to host a year-end celebration in 2020, down from 76 percent in 2019 - a decline of more than two thirds. And of companies who are planning on holding a holiday party, three out of four are doing so virtually.

Since the vast majority of companies who plan to celebrate are embracing virtual as the ideal way to save the day, here are some suggestions and ideas for your party planning committee to consider.

Each presidential transition brings changes to the HR and employee benefits landscape. When President Donald Trump took office in 2016, he overturned or revised many of his predecessor’s federal regulations, a common trend between administrations of opposing parties. It is also something likely to continue under President elect Joe Biden.

With any legislative change - regardless of intent or outcome - employers must adapt quickly or risk penalties. This can mean redrafting internal policies, recategorizing workers, changing organizational priorities, rewriting employee handbooks, and any other HR responsibility. Essentially, the more prepared an HR team is, the easier it will be for them to succeed in a changing landscape.

Some of the policies upon which Biden campaigned may not come to fruition. Moreover, wide-sweeping workplace changes may be stifled due to congressional gridlock, though Biden will retain the ability to affect change through executive orders.

However, thinking about these issues early can help inform operational planning and prevent last-minute scrambling when change arrives. To that end, this week’s blog post discusses potential changes employers can expect during a Biden presidency. Here are nine areas to watch;

As of yesterday, Arizona’s new law legalizing recreational marijuana usage began its phased roll-out. Joining Arizona this year in passing less restrictive marijuana laws are Montana, New Jersey, and South Dakota, all of whom legalized recreational marijuana, and Mississippi, who voted in favor of legalizing medical marijuana.

While all marijuana use remains illegal under federal law, the approval of recreational/medical marijuana use at the local level in these states impacts the drug use policies and procedures employers have in place for both applicants and employees. These include how employers can approach testing and disciplinary procedures.

These states are not, of course, the first to legalize marijuana. Eleven other states previously voted in favor of recreational marijuana laws, and 22 have passed medical marijuana legislation. It is therefore helpful to use the experiences of employers in these states as an example to follow.

In this post we will discuss federal and state marijuana legislation, employer and employee rights and responsibilities, specifics about the five states enacting new legislation, and steps employers can take now to be prepared as these new laws roll out.

For the past 15 years United Benefit Advisors® (UBA), of whom JP Griffin Group is a proud member, has surveyed thousands of employers across the nation regarding their health plan offerings, their ongoing plan decisions in the face of significant legislative and marketplace changes, and the impact of these changes on their employees and businesses. 

The UBA Health Plan Survey has become the nation’s largest independent health plan benchmarking survey and the most comprehensive source of reliable benchmarking data for employers. 

In fact, UBA’s survey is nearly three times larger than the nations’ next two largest health plan benchmarking surveys combined. The resulting volume of data provides employers of all sizes more detailed—and therefore more meaningful—benchmarks and trends than any other source.

UBA recently released its 2020 Employee Benefits Health Plan Survey. This year’s survey aggregates inputs from over 11,788 employers, 21,980 health plans, and 1.3 million nationwide employees. 

The scope of this year’s survey allows regional, industry-specific, and employee size differentials to emerge from the data. In addition, the large number of plans represented allows for both a broader range of categories by plan type than traditionally reported, and a larger number of respondents in each category.

Employers looking to decrease their healthcare costs often rely on workforce adoption of High Deductible Health Plans (HDHPs), which offer both employers and employees lower premiums. Unfortunately, if employees are given a choice, this strategy doesn’t always work if enrollment in HDHPs fall short of forecasts.

Rightly or wrongly, HDHPs have been saddled with some baggage. Many people have difficulty making the cognitive leap from traditional healthcare plans to HDHPs for a variety of reasons; in part because change is generally difficult for people, but sometimes, it’s simply a fear of the unknown and a matter of not understanding how they work.

While we certainly aren’t advocating that HDHPs are suitable for everyone, they’re a great fit for some. Particularly, those who are otherwise overpaying for health insurance, meaning that they’re paying high premiums, but rarely using their plans.

Here are some reasons your employees might not be enrolling in your HDHP — and how you can increase HDHP enrollment.

As healthcare costs rapidly started to rise in the 2000s, insurance companies started to push high deductible health plans, which came with lower monthly premiums, but higher than average deductibles. That trend has continued to the present day, where HDHPs (high deductible health plans) are as popular as ever among employers.

According to the Kaiser Family Foundation, employers offering HDHPs with some kind of savings option has increased 25 percent over the past decade. In fact, 29 percent of workers covered by employer-sponsored health plans are now enrolled in a high deductible health plan.

One of the major perks of being enrolled in an HDHP is the ability for employees to open and contribute to an HSA (health savings account) — but what many employers (and employees) don’t realize is that not all health plans with high deductibles are eligible for this benefit. So how do you know if your high deductible health plan is HSA qualified?

What is an HSA?

An HSA is a tax-advantaged savings account designated for qualifying health expenditures. This means that funds which employees, employers (or both) contribute to an HSA are not subject to tax, thereby lowering the participant's taxable income for the year. While participants can contribute any amount they like, the government caps tax-advantaged funds for 2021 at $3,600 for individuals and $7,200 for families. 

For people who have experience with FSAs (flexible spending accounts), the concept is very similar. FSAs, designed to offset health and dependent care expenses, are sometimes made available through employer-sponsored benefit programs. The main difference is that funds contributed to an FSA  “expire” at the end of year in what’s called the “use it or lose it” rule. Net, if FSA participants don’t use their entire contribution, they forfeit whatever is left over.

The Kaiser Family Foundation (KFF) recently published the results of their highly anticipated Employer Health Benefits Survey for 2020. This year’s survey includes data from 1,765 non-federal private and public companies in the United States.

KFF’s annual report provides an in-depth perspective on trends in employer-sponsored health coverage. Their results span everything from medical premiums and funding mechanisms to wellness and health plan design.

The following is a summary of some important trends for you to know, along with a link towards the end of our summary for you to download the full report.